1. Second Medicaid Congress June 14, 2007
Emerging Private Long-Term Care Financing Innovations
Jean Wood, Division Director, Aging and Adult Services
Minnesota Department of Human Services MC

2. Long-Term Care Financing Innovations
Project 2030 established:
Increasing number of older persons which is permanent
Medicaid was not sustainable as is into the future
Home and community-based services were key
Private financing strategies were necessary
Highly data driven
Next few slides show examples of measures used MC

3. Track1.02--Wood--6.14@10.45am MC Vision for 2030
“Long term care” becomes “long term support.”
People take responsibility for their own self-care, with greater choice and access to individually controlled services.
People obtain and pay for long term support with a variety of options.
Increase Minnesota savings rate and level of long term care insurance coverage:
Develop employer-based education programs for life-cycle financial and social planning.
Develop and offer LTC insurance product to public employees in Minnesota.
Trends For Future Aging Services
More people--longer lives--more diverse
Less family stretched further, not close by
Small growth in public support (outside of Social Security, Medicare)
More pressure on “quasi-formal” and community-based services
DHS Redesign Priorities for 2030
Redesign of Nursing Facility Payments
Prepare a plan for smooth transition from cost-based reimbursement (under Rule 50 which will sunset in 2000) to performance-based contracts with nursing facilities.
Reduce disability rates in Minnesota:
Include monitoring of disability rates in Minnesota Milestones or Aging Report Card.
Work with Department of Health and other partners on setting goals for reduction in disability rates. MC

4. Public Resources vs. Demand
Vision for 2030
“Long term care” becomes “long term support.”
People take responsibility for their own self-care, with greater choice and access to individually controlled services.
People obtain and pay for long term support with a variety of options.
Increase Minnesota savings rate and level of long term care insurance coverage:
Develop employer-based education programs for life-cycle financial and social planning.
Develop and offer LTC insurance product to public employees in Minnesota.
Trends For Future Aging Services
More people--longer lives--more diverse
Less family stretched further, not close by
Small growth in public support (outside of Social Security, Medicare)
More pressure on “quasi-formal” and community-based services
DHS Redesign Priorities for 2030
Redesign of Nursing Facility Payments
Prepare a plan for smooth transition from cost-based reimbursement (under Rule 50 which will sunset in 2000) to performance-based contracts with nursing facilities.
Reduce disability rates in Minnesota:
Include monitoring of disability rates in Minnesota Milestones or Aging Report Card.
Work with Department of Health and other partners on setting goals for reduction in disability rates.
Growing gap between needs and public resources for long term care. MC

5. Numbers of at Risk Elders
Vision for 2030
“Long term care” becomes “long term support.”
People take responsibility for their own self-care, with greater choice and access to individually controlled services.
People obtain and pay for long term support with a variety of options.
Increase Minnesota savings rate and level of long term care insurance coverage:
Develop employer-based education programs for life-cycle financial and social planning.
Develop and offer LTC insurance product to public employees in Minnesota.
Trends For Future Aging Services
More people--longer lives--more diverse
Less family stretched further, not close by
Small growth in public support (outside of Social Security, Medicare)
More pressure on “quasi-formal” and community-based services
DHS Redesign Priorities for 2030
Redesign of Nursing Facility Payments
Prepare a plan for smooth transition from cost-based reimbursement (under Rule 50 which will sunset in 2000) to performance-based contracts with nursing facilities.
Reduce disability rates in Minnesota:
Include monitoring of disability rates in Minnesota Milestones or Aging Report Card.
Work with Department of Health and other partners on setting goals for reduction in disability rates.
By 2050, numbers of 85+ in Minnesota will almost quadruple; the rest of the population will increase by only 25%. MC

6. Long-Term Care Financing Innovations
Transform 2010 establishes a broad plan:
Long-term care reform of 2001
Partnership of Human Services, State Unit on Aging and Health Department
Local and state, private and public, all ages have a role
Public presentations
State agency group

7. Long-Term Care Financing Innovations
Transform 2010 establishes areas:
Redefining work and retirement
Supporting caregivers of all ages
Fostering communities for a lifetime
Improving health and long-term care

8. Long-Term Care Financing Innovations
Prevent hitting the safety net
Helping people to help themselves
Improving chronic care outcomes
Building a sustainable long-term care system of care
Labor shortages

9. Long-Term Care Financing Innovations
Long-Term Care Insurance Partnership program (DRA)
Affordable
Attractive to middle income persons
Long term savings
Partnership with Health Care Eligibility and Commerce (insurance commission)

10. Long-Term Care Financing Innovations
Caregiver support
Debate of tax credit vs targeted program
Implementation of a tax credit—who, how long, what level
Full array of services covered by public programs
Paid time off and cafeteria insurance benefits
Employer support

11. Long-Term Care Financing Innovations
Quasi formal service system
Communities for a lifetime
Volunteer and locally driven
Faith-based organizations
Sustainable
Quality challenges

12. Long-Term Care Financing Innovations
Reverse Mortgage
Legislative proposal
Connected to Alternative Care eligibility (state funded)
Housing worth up to $150,000
Strong rural potential

13. Long-Term Care Financing Innovations
Aging and Disability Resource Centers
Good information leads to good decisions
Helping people to help themselves
LinkAge Line strategy—telephone and one on one
Minnesotahelp.info as database
Outreach and enhanced outreach and help
Help in medical clinics

14. Long-Term Care Financing Innovations
Contact:
Jean Wood